The Seattle Heart Failure Model: Prediction of survival in heart failure

Wayne C. Levy, Dariush Mozaffarian, David T. Linker, Santosh C. Sutradhar, Stefan D. Anker, Anne B. Cropp, Inder Anand, Aldo Maggioni, Paul Burton, Mark D. Sullivan, Bertram Pitt, Philip A. Poole-Wilson, Douglas L. Mann, Milton Packer

Research output: Contribution to journalArticle

1219 Scopus citations

Abstract

Background - Heart failure has an annual mortality rate ranging from 5% to 75%. The purpose of the study was to develop and validate a multivariate risk model to predict 1-, 2-, and 3-year survival in heart failure patients with the use of easily obtainable characteristics relating to clinical status, therapy (pharmacological as well as devices), and laboratory parameters. Methods and Results - The Seattle Heart Failure Model was derived in a cohort of 1125 heart failure patients with the use of a multivariate Cox model. For medications and devices not available in the derivation database, hazard ratios were estimated from published literature. The model was prospectively validated in 5 additional cohorts totaling 9942 heart failure patients and 17 307 person-years of follow-up. The accuracy of the model was excellent, with predicted versus actual 1-year survival rates of 73.4% versus 74.3% in the derivation cohort and 90.5% versus 88.5%, 86.5% versus 86.5%, 83.8% versus 83.3%, 90.9% versus 91.0%, and 89.6% versus 86.7% in the 5 validation cohorts. For the lowest score, the 2-year survival was 92.8% compared with 88.7%, 77.8%, 58.1%, 29.5%, and 10.8% for scores of 0, 1, 2, 3, and 4, respectively. The overall receiver operating characteristic area under the curve was 0.729 (95% CI, 0.714 to 0.744). The model also allowed estimation of the benefit of adding medications or devices to an individual patient's therapeutic regimen. Conclusions - The Seattle Heart Failure Model provides an accurate estimate of 1-, 2-, and 3-year survival with the use of easily obtained clinical, pharmacological, device, and laboratory characteristics.

Original languageEnglish (US)
Pages (from-to)1424-1433
Number of pages10
JournalCirculation
Volume113
Issue number11
DOIs
Publication statusPublished - Mar 2006

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Keywords

  • Diuretics
  • Heart failure
  • Hemoglobin
  • Lymphocytes
  • Prognosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Levy, W. C., Mozaffarian, D., Linker, D. T., Sutradhar, S. C., Anker, S. D., Cropp, A. B., ... Packer, M. (2006). The Seattle Heart Failure Model: Prediction of survival in heart failure. Circulation, 113(11), 1424-1433. https://doi.org/10.1161/CIRCULATIONAHA.105.584102